Waist-to-height ratio and dynapenic abdominal obesity in users of hemodialysis services

Abstract

Background and aims: Abdominal obesity and decreased muscle strength are risk factors for individuals on hemodialysis. Thus, the combination of these two factors known as dynapenic abdominal obesity acts as an important marker of the nutritional status of this population. Therefore, the objective of the work was to investigate the association between abdominal obesity, dynapenia, and sociodemographic, clinical, and nutritional factors in individuals with chronic kidney disease undergoing hemodialysis.

Methods and results: Cross-sectional study with 940 individuals undergoing hemodialysis in southeastern Brazil. Dynapenic abdominal obesity was defined by the combination of the presence of abdominal obesity, indicated by the waist-to-height ratio, and the reduction in muscle strength, measured by handgrip strength. Binary logistic regression was performed to calculate the odds ratio (OR) and the respective confidence intervals (95% CI). Dynapenic abdominal obesity was present in 45.42% of the study population. We found that being 18-59 years (OR: 3.17; 95% CI 2.35-4.28; p < 0.001) and being overweight (OR: 2.58; 95% CI 1.92-3.47; p < 0.001) increased the chances for the presence of dynapenic abdominal obesity; however, the habit of consuming meals away from home (OR: 0.63; 95% CI 0.47-0.85; p = 0.003) and having preserved behavioral adductor muscle thickness (OR: 0.52; 95% CI 0.38-0.71; p < 0.001) are considered protective factors.

Conclusion: Dynapenic abdominal obesity, present in individuals on hemodialysis, may represent a valid nutritional tool for assessing cardiovascular risk and mortality in this population, in order to implement the most effective preventive and/or therapeutic intervention possible.

Keywords: Abdominal obesity; Chronic kidney disease; Dynapenia; Hemodialysis.